Authors:Akshyaya Kumar Pradhan, Vikas Gupta, Pravesh VishwakarmaPages: 3 - 7Abstract: Akshyaya Kumar Pradhan, Vikas Gupta, Pravesh VishwakarmaHeart India 2019 7(1):3-7Aspirin has been a widely used antiplatelet drug for management of cardiovascular disease for last five decades. Multiple studies have established its role in secondary prevention of cardiovascular diseases. For primary prevention, the situation is not so simple. Initial studies (though large and with long follow up) performed two decades ago suggested an impressive positive risk -benefit profile. But such benefits could not be replicated in subsequent studies performed in the new millennium. Recently, three back to back studies of aspirin in primary prevention in contemporary era failed to demonstrate any benefits or the benefits were counterbalanced by bleeding events. Hence, the role of aspirin for primary prevention of cardiovascular disease is under intense scrutiny.Citation: Heart India 2019 7(1):3-7PubDate: Fri,29 Mar 2019DOI: 10.4103/heartindia.heartindia_5_19Issue No:Vol. 7, No. 1 (2019)

Authors:Suresh Madhavan, Jayaprasad NarayanapillaiPages: 14 - 20Abstract: Suresh Madhavan, Jayaprasad NarayanapillaiHeart India 2019 7(1):14-20Aim: Incidence, diagnosis, and management of spontaneous coronary artery dissection (SCAD) in the Indian subcontinent are less well understood. The present study is to find the incidence and clinical features of SCAD in acute coronary syndrome (ACS) patients undergoing coronary angiography in acute coronary settings.Subjects and Methods: This is a prospective and retrospective analysis conducted on ACS patients who underwent emergency angiogram in the Department of Cardiology, Government Medical College, Kottayam, India, from February 19, 2008, to December 31, 2017. Those without SCAD were kept as control.Results: Out of 3708 patients studied, SCAD was seen in 5.9% patients with 78.8% females and was responsible for 31.4% and 6% of ACS in females aged <50 and >50 years, respectively. The mean age of presentation was 47.2 years. Age <50 years, female sex, emotional and physical stress, and fibromuscular dysplasia (FMD) were the risk factors identified. In-hospital and 6-month mortality rate was 3.1% and 6.3%. 31.9% of SCAD patients were diagnosed to have FMD on follow-up. Only 4.1% of patients belonged to peripartum period. Medical management is superior in hemodynamically stable SCAD patients compared to invasive strategies.Conclusions: SCAD is far more common than expected in this part of the world, and the awareness regarding the diagnosis, treatment, and follow-up has to be improved.Citation: Heart India 2019 7(1):14-20PubDate: Fri,29 Mar 2019DOI: 10.4103/heartindia.heartindia_1_19Issue No:Vol. 7, No. 1 (2019)

Authors:Bijaya Nanda Naik, Srikanta Kanungo, T MahalakshmyPages: 21 - 25Abstract: Bijaya Nanda Naik, Srikanta Kanungo, T MahalakshmyHeart India 2019 7(1):21-25Introduction: Hypertension is a chronic disease which necessitates daily medication intake and changes in the lifestyles. This may influence the quality of life.Aims and Objective: The aim of the study was to compare the health-related quality life of hypertensive individuals and age- and gender-matched nonhypertensive individuals in an urban area of Puducherry.Setting and Design: The cross-sectional analytical study was conducted as facility as well as community-based study.Methodology: The study involved 101 hypertensive patients attending the outpatient department of an Urban Health Training Center and 101 age- and gender-matched nonhypertensive individuals recruited from the community. The health-related quality of life (HRQoL) was measured using Short Form-12 (SF-12) questionnaire. The HRQoL was expressed in eight domains: physical functioning, physical role play, bodily pain, general health, vitality, emotional role play, social functioning, and mental health. The data were entered in Epidata software, and analysis with unpaired t-test was done using SPSS software for comparison of scores between the two groups.Results: The hypertensive individuals were found to have lower quality of life in both physical and mental domains compared to nonhypertensive individuals. The physical functioning, bodily pain, and general health domains of physical component recorded statistically significant difference.Conclusion: Hypertensive individuals have poor quality of life, especially in physical component domain in our study population. Hypertensive individuals merit a vulnerable population and need special focus by health-care providers in the context of achieving universal health coverage and sustainable goals.Citation: Heart India 2019 7(1):21-25PubDate: Fri,29 Mar 2019DOI: 10.4103/heartindia.heartindia_40_18Issue No:Vol. 7, No. 1 (2019)

Authors:PG Anish, Narayanapillai Jayaprasad, Suresh Madhavan, Raju GeorgePages: 26 - 30Abstract: PG Anish, Narayanapillai Jayaprasad, Suresh Madhavan, Raju GeorgeHeart India 2019 7(1):26-30Context: Cirrhosis is the leading cause for hepatic transplantation worldwide. Heart is one of the most adversely affected organs in cirrhosis and it increases morbidity and mortality in these patients.Aims: The objective of this study is to identify the echocardiographic abnormalities in patients with cirrhosis and their relation to severity of cirrhosis.Subjects and Methods: An observational study was done on patients with cirrhosis (n = 55) and age- and sex-matched controls (n = 30). Detailed echocardiographic examination including 2D, M-mode, pulsed-wave Doppler, tissue Doppler, and 2D speckle-tracking imaging was performed. Severity of cirrhosis was defined by model for end-stage liver disease (MELD) score. Comparison of various echo parameters among cases and controls and among the two groups with MELD score >12 and <12 was made.Results: The major echocardiographic abnormalities noticed were left ventricular hypertrophy in 47.3%, diastolic dysfunction in 40%, pulmonary artery hypertension in 32.7%, and pericardial effusion in 3.6% of patients. Among the various echocardiographic parameters, mitral annular velocity, deceleration time, isovolumetric relaxation time (IVRT), Sm velocity, e' velocity, E/e' ratio, and average global longitudinal strain (GLS) were significantly different in cirrhosis patients compared to the control population. Mitral annular a velocity and IVRT were significantly more in cirrhotic patients with MELD score >12.Conclusions: Cirrhosis is associated with increased LV mass and cardiac output. Diastolic dysfunction was present in 40% of patients. Although systolic function by ejection fraction was normal in cirrhotic patients, GLS was less compared to controls.Citation: Heart India 2019 7(1):26-30PubDate: Fri,29 Mar 2019DOI: 10.4103/heartindia.heartindia_37_18Issue No:Vol. 7, No. 1 (2019)